Provider Demographics
NPI:1831972819
Name:BROSS, MORGAN (MA, CF-SLP)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:BROSS
Suffix:
Gender:F
Credentials:MA, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 SHERWOOD ESTATES LN
Mailing Address - Street 2:
Mailing Address - City:HANNIBAL
Mailing Address - State:MO
Mailing Address - Zip Code:63401-2592
Mailing Address - Country:US
Mailing Address - Phone:573-231-9893
Mailing Address - Fax:
Practice Address - Street 1:21700 HIGHWAY 19
Practice Address - Street 2:
Practice Address - City:CENTER
Practice Address - State:MO
Practice Address - Zip Code:63436-2253
Practice Address - Country:US
Practice Address - Phone:573-267-3341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-15
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023027364235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist